Rapid and Rational Echocardiographic-Assisted Management of Cardiogenic Shock After Coronary Artery Bypass Surgery

Abstract

IN THE EARLY 1980s, when transesophageal echocardiography (TEE) was first used in the operating room, its main application was the assessment of global and regional left ventricular function. 1 Kahn R.A. Intraoperative echocardiography. in: Kaplan J.A. Reich D.L. Kondstadt S.N. Cardiac Anesthesia. (ed 4). WB Saunders, Philadelphia, PA1999: 401-483 Google Scholar Since then, there have been numerous technical advances in TEE, and the number of clinical applications has markedly increased. 1 Kahn R.A. Intraoperative echocardiography. in: Kaplan J.A. Reich D.L. Kondstadt S.N. Cardiac Anesthesia. (ed 4). WB Saunders, Philadelphia, PA1999: 401-483 Google Scholar The American Society of Anesthesiologists has published practice guidelines for the use of perioperative TEE, but the role and effect of TEE outside the cardiac operating room are still poorly explored. 2 Denault A.Y. Couture P. McKenty S. et al. Perioperative use of transesophaegal echocardiography by anesthesiologists Impact in non-cardiac surgery and in the intensive care unit. Can J Anesth. 2002; 49: 287-293 Crossref PubMed Scopus (89) Google Scholar The clinical applications of TEE have been studied in many conditions and gradually applied in the critical care setting. Echocardiography has been applied perioperatively with a limited but focused purpose, to diagnose rapidly developing perioperative hemodynamic collapse. 3 Cahalan M. Rescue transesophageal echocardiography. IARS review course lecture. Anesth Analg. 2004; 98: 10-13 Google Scholar , 4 Augoustides J. Weiss S.J. Pochettino A. Hemodynamic monitoring of the postoperative adult cardiac surgical patient. Semin Thorac Cardiovasc Surg. 2000; 12: 309-315 Abstract Full Text PDF PubMed Scopus (11) Google Scholar , 5 Griffin M.J. Hines R.L. Management of perioperative ventricular dysfunction. J Cardiothorac Vasc Anesth. 2001; 5: 90-106 Abstract Full Text Full Text PDF Scopus (17) Google Scholar